T. S. Eliot once claimed that “some forms of illness are extremely favorable, not only to religious illumination, but to artistic and literary composition”. Eliot had less of an ear than his friend and collaborator Ezra Pound and so it isn’t surprising that he doesn’t mention music in this context. Even so, Eliot’s early work – and particularly He Do The Police In Different Voices, the first version of The Waste Land, which Pound subsequently “improved” – is full of jazz rhythms, savage syncopations, double-time verbal dances where the words trip over one another. Eliot would have been well aware that while back in staid St Louis hot music was regarded as the journey-work of the Devil; even in sophisticated New York and London hot music was being subtly – and often not so subtly – pathologized by a conservative press. Jazz was “feverish”, “demented”, “possessed”. Even Philip Larkin, whose conservatism might reasonably be expected to have a more thoughtful veneer, uses the word “madness” to refer to just about everything that followed bebop.

Some of these thoughts were prompted by the death earlier this year of alto saxophonist Mike Osborne, who had been out of the music for the last 25 years, following a diagnosis of paranoid schizophrenia. I knew Mike briefly after he moved out of London to the quieter environment of Norfolk. By the later 1970s, he was already erratic in behavior, but still capable of squeezing an extraordinary intensity of expression through his horn. I remember seeing him with SOS – the saxophone trio with John Surman and Alan Skidmore – dancing spasmodically, almost levitating at moments as if straining for some access of feeling even more concentrated than what he was already playing. He seemed to me then, and after I met him personally later, a man whose spirit hummed like an overstretched hawser. There was, and is, though, a cause-and-effect question here: was Ozzie’s keening sound and density of musical detail a function of mental illness, or was his illness in some way the scar of creative effort that put unreasonable demands on him?

I was at the time “teaching” improvisation to a group of mental health patients and some pre-release prisoners from Norwich jail, and consequently very gung-ho about music as the healing force of the universe. I heard some remarkable things and in related projects saw some very remarkable “outsider art” produced by the same people. Skepticism of all sorts sets in with middle age, though. To trip over a conclusion early on, I’m now much less secure about any association whatever – causal, therapeutic or otherwise - between abnormal psychology and creativity. There’s a book around at the moment which in a series of thumpingly obvious moves purports to describe what goes on in our heads when we listen to music. I was briefly interested in trying to find out what happened in our brains when we played music, but there was nobody around at the time with the enthusiasm, the kit or the grant money to wire up a few willing improvisers and check out their alpha waves. How interesting would it really be?

Madness and jazz is one of those easy thematic resorts like drugs and jazz: nobody denies that the connection is there, but nobody has been able to do much more than juxtapose the two anecdotally. Eliot’s notion of a sufficient pathology for art – which is perhaps taking it further than he did – is strongly akin to Edmund Wilson’s suggestion in The Wound and the Bow that much as the suppurating wound gives the archer the strength to save the polis, so too artists are able to create because of rather than despite their psychic injuries. This is high-Romantic stuff, on a line with Goethe’s easily misunderstood Romantisch ist kranke, Klassisch ist gesund and it’s pretty dangerous because it reduces all art to some balance or imbalance of the humors.

A few years ago, the late Richard Cook and I were criticized for making reference to trumpeter Tom Harrell’s schizophrenia in a review essay on his work. “Of what possible relevance can his medical condition be?” was the (not so) rhetorical question thundered at us. Well, you might well ask. First, Tom’s illness is not a secret. He even jokes graciously about it himself, once commenting when he entered a hotel suite that it would do very well, because there was a room for each of his personalities. Secondly, anyone who has seen Harrell’s slumped, affectless frame suddenly come alive onstage when it comes time to play, almost galvanically animated by the music, and then slump back again when a solo or song has ended, has to wonder what process is at work there. In bringing the subject up, we were anxious to make it clear that we did not consider Tom Harrell to be reducible to a diagnosis (one which remains controversial) or that he was in any defined by his medical condition, merely that it had to be considered a shaping force in his life. The same is true of most of jazz’s famous junkies. Their collectable anecdotes – Bird’s collapses and disappearances, Chet falling asleep onstage – don’t add up to anything that looks, walks or quacks like a theory.

There is another tack on all of this, of course, one most vociferously and controversially espoused by my late fellow-countryman and sometime musical partner R. D. Laing. I won’t say we were friends. I regarded his attempt to dismiss schizophrenia as a socially and politically imposed illusion as both dangerous and misguided, and still do. That said, there is objective evidence (i.e. from outside his own writings) that the booze-instead-of-drugs, unlock-the-doors-and-throw-away-the-keys approach did have positive outcomes in some cases and there is no doubt that Laing exposed the easy institutional lumping-together of distressed people as a fiscal and legal necessity rather than a route to cure. He had some notion – and this is why we hooked up for a time – that in improvisation it was possible to reach into and recreate states of mind which society declared to be aberrant and dangerous. Every Scotsman carries about Dr Jekyll and Mr Hyde, or Hogg’s Justified Sinner, as if those archetypal ideas contain some profound truth about the human race rather than the Scottish nation. “Playing with Laing” – the name’s pronounced “layng” rather than “lang” – was my nervous diary entry for a series of “recitals” in Oxford and London that had no pre-determined structure other than a lot of Scotch and the instruction “Let’s go a wee bit mad.”.Ronnie often merely spoke, randomly and associatively, while I tried hard not to sound as if I was accompanying him. At other times, he would play a strange mixter-maxter of piano chords that were unexpectedly polite and conventional. The only time I thought he really had gone a wee bit mad was when his hands suddenly started to dance over the keyboard before he abruptly stopped and put them to his face: turned out a crown had fallen off a front tooth and danced about, ivory on ivory. Such was his vanity that he wouldn’t even face this tiny crowd with a gappy smile.

Jazz and improvisation enjoin on us all, as listeners or players, a long devotion and an austerity of craft that makes considerable sense of Eliot’s other example, religious revelation. If the epiphanies on offer have a very different complexion, the roads taken are not so very different. I was briefly offended to hear Mike Osborne described in The Times as “the Syd Barrett of jazz”, as if somehow he had joined some celestial asylum band. The things that turn people mad are chemistry and circumstances, with the second exerting a powerful influence on the former. Hard work, neglect, pain, hunger, failure to communicate: all these can drive you into depression and despair. There’s no evidence, though, that schizophrenia in itself either opens up to you new routes of expression or responds to musical therapy, other than as a distracting and consoling activity that might for a time take you out of the maelstrom and suggest an order that didn’t exist before. I was struck by Jacques Lacan’s early definition of the paranoid personality as a kind of existential cowboy, standing outside society, shooting from the hip, spotting connections and opportunities where no one else would. It’s a beguiling possibility and a model for the improving musician which can’t be dismissed out of hand. On the other hand, it’s probably time that we valued health and social fitness as aspects of genius, longevity and success rather than premature demise and permanent critical isolation. No one gets excited about Haydn, arguably one of the most fertile musical imaginations ever documented (and how!), because he lived long, made some cash, loved his kids and died in the normal way. Instead of fetishizing mental illness, we might do well to recognize it as a misfortune, understand its needs, make a safe place for it, and concentrate on care and cure rather than pretending that it offers some exceptional insight or creative energy. Improvisation may be a kind of insanity, a step outside the quotidian and the rule-bound, but it is also at root an expression of health: to go against the conventions and to go outside the repetitive familiarities requires mental health first and foremost. Parents learn by instinct and experience to make a distinction between their children’s cries of pain, fear, delight, hunger, sheer energy. It’s time we learned to do the same and to reach out to those who aren’t caught up in some fine improvisational frenzy but actually calling for help. There’s nothing wrong with happy music. There’s something desperately wrong about sadness being repackaged as art.